Voluntary Euthanasia


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1. Definitions of Euthanasia and Physician-Assisted Suicide


a. The terms "physician-assisted suicide" and "euthanasia" are often used interchangeably. However, the distinctions are significant.

b. "Physician-assisted suicide" involves a medical doctor who intentionally provides a patient with the means to kill him or herself, usually by an overdose of prescription medication.

c. "Assisted suicide" involves a layperson providing the patient with the deadly means for suicide.

d. "Euthanasia" involves the intentional and direct killing of a patient by a physician, most commonly by lethal injection, or by another party. Euthanasia can be voluntary (at the patient's request), non-voluntary (without the knowledge or consent of the patient), or involuntary (against the patients wishes).

e. It is important to note that a person can reject medical treatment at the end of life without committing euthanasia or physician-assisted suicide.


2. Physician-assisted suicide and euthanasia are legal and widely practiced in the Netherlands where:


a. About 9% of all deaths were a result of physician-assisted suicide or euthanasia in 1990. (1, 2)

b. Dutch doctors practice active euthanasia by lethal injections (96.6% of all deaths actively caused by physicians in 1990). Physician-assisted suicide is very infrequent (no more than 3.4% of all cases in Holland of active termination of life in 1990). (3)

c. For patients who die of a lethal overdose of painkillers, the decision to administer the lethal dose of drugs was not discussed with 61% of those receiving it, even though 27% were fully competent. (4)

d. The Board of the Royal Dutch Medical Association endorsed euthanasia on newborns and infants with extreme disabilities. (5)

e. Well over 10,000 citizens now carry "Do Not Euthanize Me" cards in case they are admitted to a hospital unexpectedly. (6)

f. Cases exist where doctors administer assisted suicide for people determined to be "chronically" depressed. (7,8)


3. Oregon is the only state that has legalized physician-assisted suicide where:


a. A recent Health Division report of assisted suicides reveals that not one patient had documented uncontrollable pain. All of the patients who requested assisted suicide cited psychological and social concerns as their primary reasons. (9)

b. "Although numerous studies in the Netherlands and elsewhere report an assisted-suicide failure rate up to 25%, Oregon has yet to report even one complication in over four years. This failure to report complications has led even euthanasia advocates themselves to call the credibility of Oregon reporting on assisted suicide into question." (10)


4. The U.S. Supreme Court ruled in 1997 in Washington v. Glucksberg that there is no federal constitutional substantive right to assisted suicide. (11) In a 1997 companion case, the U.S. Supreme Court ruled in Vacco v. Quill that there is no federal constitutional equal protection right to assisted suicide. (12)

5. Virtually every established medical and nursing organization in the United States declares physician-assisted suicide is unethical.

6. There are no laws, medical associations, church denominations, or right-to-life groups who insist that unnecessary, heroic, or truly futile treatments be provided to prolong life and all recognize the right of competent patients to refuse medical treatment. (13)

7. 95% of cancer pain is controllable and the remaining 5% can be reduced to a tolerable level. (14)

8. The states of California, Washington, Michigan and Maine rejected ballot referenda questions to legalize physician-assisted suicide in their respective states. The Supreme Court of Alaska in Alaska v. Sampson declared there is no state constitutional right to physician-assisted suicide, (15) as did the Florida State Supreme Court in McIver v. Kirscher. (16) The Hawaii State Senate voted down a bill to legalize physician-assisted suicide.


References

1. J. Remmelink et al., "Medical Decisions About the End of Life": Report of the Committee to Study the Medical Practice Concerning Euthanasia, SDU Publishing House, The Hague, 1991.

2. Van der Maas, P.J., van Delden, J.J.M., Pijnenborg, L., "Euthanasia and other medical decisions concerning the end of life." Elsevier, Amsterdam-London-New York-Tokyo 1992, 73 tabl. 7.2, 75 tabl. 7.7, 138 tabl. 13.8, 178-9, 182-3.

3. Remmelink Report, vol. II, p. 61, Table 7.7.

4. Ibid.

5. Royal Dutch Society of Medicine: "Answers to questions asked by State Committee on Euthanasia," Medisch Contact 1984, 39, 999.

6. The Levenswensverklaringen (Declarations of the Will to Live) have been printed and distributed by two associations in Holland since 1985.

7. "The Supreme Court abolishes the discrimination between psychological and bodily suffering: The ... more

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Euthanasia, which means "good" or "peaceful" death, has been practiced  through the
ages.  Doctors have always been dedicated to the task of easing pain and suffering, to make
dying easier.  Adding the adjective "active" alters the meaning of euthanasia.  The emphasis shifts
from comforting the dying to inducing death.  The practice of voluntary euthanasia and assisted
suicide would cause society to devalue all life,  especially the lives of the dying, the disabled, and
the elderly.                                                                                                                                  
We should not understate the agonies involved in chronic pain and suffering.  Nobody
wants to see a loved one suffer or make the decisions that accompany medical science's ability
to prolong life.  The same technology that keeps people alive today  raise a host of questions
concerning the nature and destiny of man himself.  Comforting the dying is still preferable to
assisting in their death.
There are many reasons why, but the main one has to do with how much we value
human life.  God views all human life as sacred.  He created us in his own image (Genesis
1:26,27), and it is he who has determined our days on earth (Job 14:5).  God confirms his great
love for his people, a love that does not cease when we are old or ill.  His command that we not
kill one another does not change when we are brain damaged or comatose.  Our society,
however, teaches certain classes of people that they are not wanted.
If a physician's aid in dying were to become a standard part of terminal care, there is
always that possibility that patients might feel the need to request death out of fear of becoming a
burden to their families.  The right to die could be interpreted by a patient as the duty to die.
Chronically ill or dying patients may be pressured to choose euthanasia to spare their families
financial or emotional strain.  Joan Farah states in the New England Journal of Medicine that the
elderly are often cited as being vulnerable.  If Euthanasia becomes the law


of the land, how long will it take before the elderly and sick begin to feel an obligation to get out
of the way?
There are many complicated ethical and medical issues involved in the discussion of
euthanasia.  The decisions that family members must make are often as painful as the conditions
of their loved ones.  Sometimes the families react with wisdom and compassion.  However,
under stress human beings can make the wrong decisions.  In an attempt to avoid such risk we
dare not enact legislature that will allow murder simply to make decisions easier.
Opponents contend that legalized euthanasia would force medical professionals and
patients' families to judge the worth of others' lives.  Once a vulnerable group is denied a basic
right to life, it is only a matter of time until other groups are placed in the same category.  We
have accepted the killing of unborn children, allowed children born with severe handicaps to die,
and have ignored "mercy killing" of consenting adults.  Will we tolerate or accept euthanasia just
as we do abortion?
There are no easy answers when a loved one faces death.  Scientists must continue to
seek answers and cures.  Active euthanasia does not provide answers:  it only tries to avoid the
hardest questions.  Thomas Beauchamp, a bioethicist of Georgetown University has written,
rules against killing "are not isolated moral principles," but "pieces of a web of rules" that forms a
moral code.  "The more threads one removes the weaker the fabric becomes."  Allowing
ourselves the liberty of choosing the time and place of death will not lessen our sense of  loss.  It
can only erode the wonder of human life and the worth of each individual.

Wekesser, Carol, ed.  Euthanasia:  Opposing Viewpoints.  San Diego:  Greenhaven Press,
1995.

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